Abstract
PURPOSE: Normative values of bone mass, bone turnover markers (BTMs) and muscle-bone unit (MBU) among healthy Asian children are needed to enable accurate skeletal assessment. This cross-sectional study characterizes the bone mineral density (BMD), bone mineral content (BMC), BTMs and MBU of 243 Malaysian preadolescent children aged 9-11 years. METHODS: The total body BMD (TBBMD), total body BMC (TBBMC), lumbar spine BMD, lumbar spine BMC, and body composition were assessed using dual-energy x-ray absorptiometry. Total and regional MBU were calculated by dividing BMC by lean body mass. Serum BTMs (c-terminal telopeptide 1, procollagen type 1 N propeptide, bone alkaline phosphate, osteocalcin) and serum intact parathyroid hormone were measured. RESULTS: Based on the Asian reference population, 97.5% of participants had TBBMD z-scores above -1 standard deviation (SD), 2.5% were at risk for low TBBMD for age (-1.9 to -1.0 SD) and no one had low TBBMD for age (<-2.0 SD). Participants had lower TBBMD values compared to children of the same age according to published data of Asian children despite having higher body weights. There were sex-specific differences in the BTMs and regional MBU of study participants. CONCLUSION: This study provides a population-based dataset on bone mass, BTMs, and MBU of healthy preadolescent Malaysian children, which enables accurate skeletal assessment in this population.